Important measles update
Ontario continues to see a rise in measles cases.
This highly contagious virus spreads through coughing, sneezing, and talking. Infectious droplets may remain airborne for up to two hours. Transmission can also occur via contact with contaminated surfaces.
According to the College’s IPAC Standard, dental offices must have a written policy for managing patients with suspected febrile respiratory, rash, and eye infections. Measles meets this classification. Dentists must screen patients for symptoms of measles when confirming appointments and upon arrival. Patients who are ill are to be rescheduled.
Signs and symptoms of measles:
• Fever (≥ 38.3◦C)
• Cough
• Runny nose
• Conjunctivitis
• Koplik spots (tiny blue-white spots on the buccal mucosa)
• Red maculopapular non-itchy rash which starts on the face and spreads downward.
Dentists should consider measles in patients presenting with the above signs and symptoms, especially for patients who have recently traveled or if there is an ongoing measles outbreak in their area.
Suspected cases of measles must be reported to the local public health unit immediately.
Managing patients with suspected measles
Symptomatic patients should be advised to self-isolate until they can be evaluated by a physician. If a referral is necessary, the dentist should contact the receiving facility to ensure IPAC measures are in place.
For patients requiring emergency dental care, provide a medical mask and isolate the patient in a separate room with the door closed. PHO recommends that all healthcare workers, regardless of immune status, wear an N95 mask when interacting with a presumptive measles case.
Follow the College’s IPAC Standard for disinfecting both clinical and non-clinical surfaces after possible measles exposure. Additionally, remind staff that immunization is the most effective way to prevent measles infection. Encourage staff to verify their vaccination status and ensure it is up to date.
Dental offices should also implement a protocol for potential exposure. Post-exposure prophylaxis may be an option, however, it must be typically administered within 72 hours. For more details, please refer to: Measles: Post-Exposure Prophylaxis for Contacts.
Questions? Contact practiceadvisory@rcdso.org.